Cataract is the most common cause of blurry vision complaints in the elderly.
What is Cataract?
A cataract is a clouding or opacification of the normally clear crystalline lens of the eye. Most cataracts develop as part of the normal ageing process. The age at which cataract develop varies from person to person. While some may start developing cataracts in their forties, most do so only in their sixties to seventies. The rate of progression also varies from person to person. In some, the cataract slowly becomes more dense or ‘mature’ over many years, while in others the cataract may mature in matter of weeks.
It is not true that cataracts can spread from eye to eye, although they are generally found in both eyes. The degree of cataract ‘maturity’ between two eyes is usually different. Therefore, vision in one eye is often described as better than the other. There is no evidence that excessive use of the eyes such as reading or watching television has any effect on the development of cataracts.
Not all cataracts are age-related. Cataracts can also occur from eye injury, taking certain medications, hereditary conditions or foetal infection with viruses such as rubella. Cataract can also occur more often in patient with diabetes and high myopia
Blurry vision from Cataract
The main complaint of a person with cataracts is blurred vision. In early cataracts, the blurred vision is often described as worse under strong sunlight or when the light is bright or when reading. Glare is another common complaint, especially when driving at night. As the cataract matures, the vision gets more and more blurred and colours appear less strong.
In some early cataracts, vision may be improved slightly with corrective lenses. As the cataract matures, frequent changes of glasses are necessary and at some point, lenses will not help anymore.
Treatment for Cataract
The only treatment available for a cataract that is causing poor vision is to remove it by surgery and place it with an artificial lens implant made of acrylic or silicone. There are no eye drops, pills or diets that are of proven value in curing cataracts. Laser too cannot be used to remove cataracts.
The good news about cataracts is that good vision can be restored in well over 95 per cent of cases. Most cases of poor vision after cataract surgery are in fact due to eye diseases such as glaucoma and retinal diseases which exist even before surgery.
When to go for Cataract Surgery?
The time to go for cataract surgery is when the cataract handicaps vision enough to interfere with your normal daily activities. It is not necessary to remove a cataract jus because it is there, unless it is very mature, in which case there is risk of complications such as iritis or glaucoma developing. Vision will of course be very poor.
Some time ago, patients were advised to wait until a cataract became mature or ‘ripe’ before removing it. However, with today’s advances in surgical techniques, safe removal of cataract is possible even at a very early stage.
Usually only one eye (the eye with the worse vision) is operated on first. Once healing is complete in that eye and good vision restored, a decision can be made regarding surgery for the other eye.
Modern Cataract Surgery
Most cataract surgery today is done as day surgery. This means that the patient comes into hospital for the operation and goes home after the surgery without the need for hospitalization. The operation is usually carried out under local anaesthesia.
Some numbing eyedrops will be placed into the eye. The patient will be able to feel slight pressure but no pain.
A small incision is made at the side of the cornea. The front part of the capsule is next removed and an ultrasonic probe inserted to remove the cataractous lens. The rest of the capsule is left behind to hold the artificial lens implant. Usually no stitches are necessary. The procedure takes less than 30 minutes. A protective eye shield is place on the eye and the patient can go home after an hour’s rest.
At home, the patient may resume most activities except those involving any heavy lifting or exercise. No special dietary restriction is necessary except avoidance of heavy consumption of alcohol. For the first few weeks, it is important to protect the eye at all times with a protective eye shield.
It may take up to six months for the eye to be completely healed. During this period, it is important that the patient keeps his appointments wit the eye doctor and not forget to use the eye drops prescribed. Usually at about 3 months post-operatively, the eye is checked for refractive errors and spectacles are prescribed if necessary.
In some cases, intra-ocular lens implantation may not be suitable. Your eye doctor will be the best person to advise.
Can Cataract Recur After Surgery?
The answer to this very commonly asked question is NO. Sometimes a cloudy opacity of the natural lens capsule which holds the implanted artificial lens in position may develop. This may blur vision enough to make it seem as if the cataract has recurred. This condition, which is sometimes called an ‘after cataract’, is easily treated by a simple procedure using a special YAG Laser to cut an opening through the opaque lens capsule.